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Alpha Angle More Useful Than Femoral Head-Neck Offset to Predict Intra-Articular Damage in Patients with FAI Undergoing Hip Arthroscopy


Benjamin G. Domb, MD
UNITED STATES

Alpha Angle More Useful Than Femoral Head-Neck Offset to Predict Intra-Articular Damage in Patients with FAI Undergoing Hip Arthroscopy

Jacob Shapira, MD, UNITED STATES Jade S Owens, BS, UNITED STATES David R. Maldonado, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Bezalel Peskin, MD, ISRAEL Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES

American Hip Institute Research Foundation, Des Plaines, Illinois, UNITED STATES

2021 Congress   Abstract Presentation   5 minutes   Not yet rated

 

Anatomic Location

Hip / Groin / Thigh

Diagnosis / Condition

Impingement

Treatment / Technique

Arthroscopy

Anatomic Structure

Cartilage Labrum

Diagnosis Method

Physical Examination X-ray

Cartilage

Cartilage Treatment

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Summary: In a multivariate analysis, factors identified as preoperative predictors of intra-articular cartilage damage in patients with FAI were age, sex, ACEA, and alpha angle.

Purpose

To identify radiographic measurements and demographics that are predictive of intra-articular cartilage damage in patients with femoroacetabular impingement (FAI) undergoing hip arthroscopy. More specifically, to compare the predictive value of alpha angle and femoral head-neck offset in determining the preoperative likelihood and severity of intra-articular cartilage damage.

Methods

Patients were included if they underwent primary hip arthroscopy between February 2008 and June 2020. A total of 13 variables were assessed in a bivariate comparison and analyzed in a multivariate logistic model. The Acetabular Labrum Articular Disruption (ALAD) and Outerbridge (OB) classifications were used to define acetabular cartilage defects. Those without damage or those with mild acetabular cartilage damage belonged to the ALAD/OB = 2 group and those with severe acetabular cartilage damage belonged to the ALAD/OB = 3 group.

Results

The multivariate logistic regression selected age, sex, anterior center-edge angle (ACEA), and alpha angle. Every additional degree in the alpha angle was associated with a 6% increase in the odds of severe acetabular cartilage damage defined as ALAD/OB = 3 (OR, 1.06 [95% CI, 0.12-8.11]). The multivariate analysis did not identify femoral head-neck offset as a predictor. The odds of severe acetabular cartilage damage were 3.73 times higher in males than females (OR, 3.73 [95% CI, 0.01-1705.96]). Higher age (per log 10 unit) was found to increase the likelihood of ALAD/OB = 3 (OR, 1.04 [95% CI, 0.13-7.75]).

Conclusions

In a multivariate analysis, factors identified as preoperative predictors of intra-articular cartilage damage in patients with FAI were age, sex, ACEA, and alpha angle. Femoral head-neck offset was not predictive, suggesting alpha angle may take precedence as a predictor of intra-articular cartilage damage. These findings may be helpful to the clinician’s efficient utilization and selection of radiographic predictors of intra-articular cartilage damage in patients with FAI undergoing hip arthroscopy.

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